| NPI | 1306832118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS008005L) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34007981) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2013-04-18 |